| NPI | 1518097690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS K. BYBEE President 208-542-0352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LCSW-26094) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2025-11-24 |